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Mølsted K, Dahl E, Skovgaard LT, Asher-McDade C, Brattström V, McCance A, Prahl-Andersen B, Semb G, Shaw B, The R. A Multicentre Comparison of Treatment Regimens for Unilateral Cleft Lip and Palate Using a Multiple Regression Model. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/02844311.1993.12005641] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Erik Dahl
- Department of Orthodontics, School of Dentistry
| | | | | | | | - Andrew McCance
- Dental Department, Craniofacial Centre, Hospital for Sick Children, London, United Kingdom
| | | | - Gunvor Semb
- Department of Plastic Surgery, University Hospital of Oslo, Norway
| | - Bill Shaw
- Division of Dentistry, Children's Hospital, Los Angeles, California, USA
| | - Ralph The
- Department of Orthodontics, Vrije University, Amsterdam, The Netherlands
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Bongaarts CAM, Kuijpers-Jagtman AM, van 't Hof MA, Prahl-Andersen B. The Effect of Infant Orthopedics on the Occlusion of the Deciduous Dentition in Children with Complete Unilateral Cleft Lip and Palate (Dutchcleft). Cleft Palate Craniofac J 2017; 41:633-41. [PMID: 15516167 DOI: 10.1597/03-051.1] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective Evaluation of the effect of infant orthopedics (IO) on the occlusion of the deciduous dentition in patients with unilateral cleft lip and palate (UCLP). Design Prospective, two-arm, randomized, controlled clinical trial with three participating cleft palate centers (Dutchcleft). Setting Cleft Palate Centers of the University Medical Center Nijmegen, Academic Center of Dentistry Amsterdam, and Dijkzigt University Hospital Rotterdam, The Netherlands. Patients Children with complete UCLP (n = 54) were included. Interventions In a concealed allocation procedure, half of the patients was randomized to wear a plate till surgical closure of the soft palate (IO+), and the other half (IO−) did not have a plate. Mean Outcome Measures Dental arch relationships were assessed at 4 and 6 years of age with the 5-year-old index; the Huddart-score; and measurements of overjet, overbite, and sagittal occlusion. Results There were no significant differences found between the IO+ and IO− groups for the 5-year-old index; the Huddart-score; and overjet, overbite, and sagittal occlusion. Conclusions IO had no observable effect on the occlusion in the deciduous dentition at 4 and 6 years of age. Considering the occlusion only, there is no need to perform IO in children with UCLP.
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Affiliation(s)
- Catharina A M Bongaarts
- Department of Orthodontics and Oral Biology, University Medical Center, Nijmegen, the Netherlands
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Noverraz RLM, Disse MA, Ongkosuwito EM, Kuijpers-Jagtman AM, Prahl C. Transverse dental arch relationship at 9 and 12 years in children with unilateral cleft lip and palate treated with infant orthopedics: a randomized clinical trial (DUTCHCLEFT). Clin Oral Investig 2015; 19:2255-65. [PMID: 25855466 PMCID: PMC4656704 DOI: 10.1007/s00784-015-1451-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 03/11/2015] [Indexed: 11/30/2022]
Abstract
Objective A long-term evaluation to assess the transverse dental arch relationships at 9 and 12 years of age in unilateral cleft lip and palate treated with or without infant orthopedics (IO). The hypothesis is that IO has no effect on the transverse dental arch relationship. Material and methods A prospective two-arm randomized controlled trial (DUTCHCLEFT) in three academic cleft palate centers (Amsterdam, Nijmegen and Rotterdam, the Netherlands). Fifty-four children with complete unilateral cleft lip and palate and no other malformations were enrolled in this evaluation. One group wore passive maxillary plates (IO+) during the first year of life, and the other group did not (IO−). Until the age of 1.5, all other interventions were the same. Hard palate was closed simultaneously with bone grafting according to protocol of all teams. Orthodontic treatment was performed when indicated. The transverse dental arch relationship was assessed on dental casts using the modified Huddart/Bodenham score to measure the maxillary arch constriction at 9 and 12 years of age. Results No significant differences were found between the IO+ and IO− groups. Differences between the centers increased from 9 to 12 years of age. Conclusions Transverse dental arch relationships at 9 and 12 years of age do not differ between children with UCLP treated with or without IO. Clinical relevance There is no orthodontic need to perform IO as applied in this study in children with UCLP.
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Affiliation(s)
- R L M Noverraz
- Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - M A Disse
- Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - E M Ongkosuwito
- Department of Orthodontics and Craniofacal Biology and Cleft Palate Craniofacial Centre, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A M Kuijpers-Jagtman
- Department of Orthodontics and Craniofacal Biology and Cleft Palate Craniofacial Centre, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - C Prahl
- Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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Liu R, Li F, Deacon SA, Li H, Chen J, Liu Z, Hu H, Wamalwa P, Qin Y, Li C, Zou S. Pre-surgical orthopaedics (PSO) for infants with complete cleft lip and palate. Hippokratia 2015. [DOI: 10.1002/14651858.cd008868.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Renkai Liu
- West China College of Stomatology, Sichuan University; Department of Orthodontics; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
| | - Fan Li
- West China College of Stomatology, Sichuan University; Department of Orthodontics, State Key Laboratory of Oral Diseases; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
| | - Scott A Deacon
- University Hospitals Bristol NHS Foundation Trust; South West Cleft Unit; Lower Maudlin Street Bristol UK BS1 2LY
| | - Honghao Li
- West China School of Medicine, Sichuan University; Chinese Evidence-Based Medicine Center; No. 37, Guo Xue Xiang Chengdu Sichuan China 610041
| | - Jianwei Chen
- West China College of Stomatology, Sichuan University; Department of Orthodontics, State Key Laboratory of Oral Diseases; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
| | - Zeping Liu
- West China College of Stomatology, Sichuan University; Department of Orthodontics; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
| | - Haikun Hu
- West China College of Stomatology, Sichuan University; Department of Orthodontics, State Key Laboratory of Oral Diseases; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
| | - Peter Wamalwa
- Kenyatta National Hospital; Department of Orthodontics; PO Box 20723 Nairobi Kenya 00202
| | - Ying Qin
- Xuzhou Medical College; Faculty of Stomatology; 209 Tongshan Road Xuzhou Jiiangsu Province China 221004
| | - Chenghao Li
- West China College of Stomatology, Sichuan University; Department of Cleft Lip and Palate Surgery; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
| | - Shujuan Zou
- West China College of Stomatology, Sichuan University; Department of Orthodontics, State Key Laboratory of Oral Diseases; No. 14, Section Three, Ren Min Nan Road Chengdu Sichuan China 610041
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Niranjane PP, Kamble RH, Diagavane SP, Shrivastav SS, Batra P, Vasudevan SD, Patil P. Current status of presurgical infant orthopaedic treatment for cleft lip and palate patients: A critical review. Indian J Plast Surg 2015; 47:293-302. [PMID: 25593413 PMCID: PMC4292105 DOI: 10.4103/0970-0358.146573] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Rehabilitation of cleft lip and palate (CLP) patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have been attempted to obtain aesthetic results. Presurgical infant orthopaedics (PSIO) was introduced to reshape alveolar and nasal segments prior to surgical repair of cleft lip. However, literature reports lot of controversy regarding the use of PSIO in patients with CLP. Evaluation of long-term results of PSIO can provide scientific evidence on the efficacy and usefulness of PSIO in CLP patients. The aim was to assess the scientific evidence on the efficiency of PSIO appliances in patients with CLP and to critically analyse the current status of PSIO. A PubMed search was performed using the terms PSIO, presurgical nasoalveolar moulding and its long-term results and related articles were selected for the review. The documented studies report no beneficial effect of PSIO on maxillary arch dimensions, facial aesthetics and in the subsequent development of dentition and occlusion in CLP patients. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip and palate patients with better long-term results.
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Affiliation(s)
- P Priyanka Niranjane
- Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Sawangi, Wardha, India
| | - R H Kamble
- Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Sawangi, Wardha, India
| | - S Pallavi Diagavane
- Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Sawangi, Wardha, India
| | - S Sunita Shrivastav
- Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Sawangi, Wardha, India
| | - Puneet Batra
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Dental Studies and Technologies, Modinagar, Kadrabad, Meerut, Uttar Pradesh, India
| | - S D Vasudevan
- Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Sawangi, Wardha, India
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Sasaguri M, Hak MS, Nakamura N, Suzuki A, Sulaiman FK, Nakamura S, Ohishi M. Effects of Hotz's plate and lip adhesion on maxillary arch in patients with complete unilateral cleft lip and palate until 5 years of age. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2014. [DOI: 10.1016/j.ajoms.2013.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Papadopoulos MA, Koumpridou EN, Vakalis ML, Papageorgiou SN. Effectiveness of pre-surgical infant orthopedic treatment for cleft lip and palate patients: a systematic review and meta-analysis. Orthod Craniofac Res 2012; 15:207-36. [DOI: 10.1111/j.1601-6343.2012.01552.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Prahl C, Prahl-Andersen B, Van't Hof MA, Kuijpers-Jagtman AM. Presurgical Orthopedics and Satisfaction in Motherhood: A Randomized Clinical Trial (dutchcleft). Cleft Palate Craniofac J 2008; 45:284-8. [DOI: 10.1597/07-045.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To study the effect of infant orthopedics on satisfaction in motherhood. Design: Prospective two-arm randomized controlled trial in parallel with three participating academic cleft palate centers. Treatment allocation was concealed and was performed by means of a computerized balanced allocation method. Setting: Cleft palate centers of Amsterdam, Nijmegen, and Rotterdam, the Netherlands. Patients: Two groups of infants with complete unilateral cleft lip and palate and no other malformations. Interventions: Group IO+ (n = 27) wore passive maxillary plates during the first year of life, group IO− (n = 27) did not. Main Outcome Measure(s): Mean satisfaction scores were obtained from completed questionnaires at 6, 24, and 58 weeks of age. A 4-point scale was used (1 = very satisfactory to 4 = very unsatisfactory). Results: The range of the mean scores for the individual items on the questionnaires for both groups ranged between 1.1 and 2.4. No differences were found between groups. Mothers appear to be satisfied in motherhood, least satisfied with the available time for themselves, and very satisfied with hugging and walking their babies. No differences were found between groups. Conclusions: Results from the present study show that infant orthopedics, with a passive plate during the first year of life, in children with a unilateral cleft lip and palate has no influence on the mothers’ satisfaction in motherhood.
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Affiliation(s)
- Charlotte Prahl
- Department of Orthodontics Academic Center for Dentistry, Amsterdam, the Netherlands, Member of the Cleft Palate Team of the Vrije Universiteit, University Medical Center, Amsterdam, the Netherlands
| | - Birte Prahl-Andersen
- Department of Orthodontics, Dijkzigt University Hospital Rotterdam, the Netherlands
| | - Martin A. Van't Hof
- Department of Preventive and Curative Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
| | - Anne M. Kuijpers-Jagtman
- Department of Orthodontics and Oral Biology and Head of the Cleft Palate Craniofacial Unit of the Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands
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Grabowski R, Kopp H, Stahl F, Gundlach KKH. Presurgical orthopaedic treatment of newborns with clefts – functional treatment with long-term effects. J Craniomaxillofac Surg 2006; 34 Suppl 2:34-44. [PMID: 17071389 DOI: 10.1016/s1010-5182(06)60009-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AIM Presentation of an orthopaedic/orthodontic treatment protocol within the framework of complex rehabilitation of patients with clefts of lip, alveolus and palate. Presurgical orthopaedic treatment aims at reduction of cleft size by guiding growth and functional rehabilitation. Long-term results of maxillary development and occlusion at young adult age are reported. PATIENTS AND METHODS 43 newborns with unilateral (19) or bilateral (24) clefts of lip, alveolus and palate were examined until their deciduous dentition was complete. In 29 patients a late follow-up was performed at age 17.3 years (mean). Maxillary dental casts were evaluated prior to and following presurgical orthopaedic treatment at the time the deciduous dentition was complete and at young adult age (2 to 5 years after termination of orthodontic treatment). Parameters were width of the alveolar and palatal cleft as well as width and length of the dental arch. In the adults occlusion was studied and the occlusal outcome was related to the therapeutical input. RESULTS Presurgical orthopaedic treatment reduced the cleft width by taking advantage of normal growth. At the age of 3 to 4 years the development of the upper dental arch was in line with that of non-cleft children. CONCLUSION Maxillary growth may be guided in almost physiological terms even in patients with a cleft of lip, alveolus and palate. Prerequisite is functional rehabilitation by means of orthopaedic treatment at age 1 to 12 months in terms of functional orthodontic therapy and a surgical protocol saving tissues with growth potential.
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Kuijpers-Jagtman AM, Long RE. The Influence of Surgery and Orthopedic Treatment on Maxillofacial Growth and Maxillary Arch Development in Patients Treated for Orofacial Clefts. Cleft Palate Craniofac J 2000. [DOI: 10.1597/1545-1569(2000)037<0527:tiosao>2.0.co;2] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
In subjects with different types of cleft palate, palatal shape and symmetry were evaluated utilizing the moiré contourography technique. The sample consisted of 95 subjects with cleft palate and 68 controls. The differences between cleft and control subjects in the transverse and anteroposterior location of the highest point of the palate, palatal axis angle, and the palatal index were assessed by analysis of variance. Effects of cleft type, gender, developmental stage of the dentition, missing teeth, and eight skeletal and pharyngeal cephalometric variables on palatal shape and symmetry were assessed using multiple-regression analyses. In comparison with the noncleft individuals, the cleft palate subjects showed parallel but clearly more remarkable asymmetry in palatal shape and position of the first maxillary molars. The anteroposterior location of the deepest point in the palate was more posterior, and the palate was relatively shallower. The severity of the cleft type affected both the anteroposterior and transverse position of the highest point in palatal morphology.
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Mishima K, Sugahara T, Mori Y, Sakuda M. Three-dimensional comparison between the palatal forms in complete unilateral cleft lip and palate with and without Hotz plate from cheiloplasty to palatoplasty. Cleft Palate Craniofac J 1996; 33:312-7. [PMID: 8827388 DOI: 10.1597/1545-1569_1996_033_0312_tdcbtp_2.3.co_2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The palatal forms in 20 infants with a complete unilateral cleft lip, and palate (12 with a Hotz palate and 8 without, selected at random) were studied from birth until 18 months of age. Using techniques developed previously, the degree of curvature in the palate and the magnitude of migration of the maxillary segments were measured three-dimensionally. Furthermore, using a newly developed method to approximate a set of the points on the alveolar ridge to a circle in a plane, the form of the alveolar arch was evaluated. Results from the group with a Hotz plate revealed that the plate possesses four effects not seen in the group without a Hotz plate. The size of the palate was larger, and the sagittal gap between the two segments of the maxilla was smaller. These results suggest that the appliance could stimulate the growth of the segments and could prevent collapse of the maxillary arch from the force of lip closure. Third, the steepness of the segments toward the nasal cavity was smaller, possibly occurring because the appliance prevents tongue intrusion into the cleft. Fourth, the magnitude of migration of the lesser segment toward the cleft edge of the major segment was larger. This result suggests that the appliance could guide the growth of the maxillary segments to narrow the cleft width until 18 months of age.
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Affiliation(s)
- K Mishima
- Second Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Osaka University, Japan
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Mishima K, Sugahara T, Mori Y, Sakuda M. Three-dimensional comparison between the palatal forms in infants with complete unilateral cleft lip, alveolus, and palate (UCLP) with and without Hotz's plate. Cleft Palate Craniofac J 1996; 33:245-51. [PMID: 8734726 DOI: 10.1597/1545-1569_1996_033_0245_tdcbtp_2.3.co_2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A three-dimensional measuring system was developed to analyze changes in palatal forms of UCLP infants. This system quantified the change of the curved surface on a palate by automatically superimposing two wireframe models obtained from casts at different stages of growth. It also analyzed the curvature of the palatal surface. This system was used to study the palates of 20 infants with unilateral cleft lip and palate (UCLP), from the first to fourth months after birth (12 with Hotz's plate and 8 without, selected at random). Both major and lesser maxillary segments without Hotz's plate remained anterior and lateral although those with Hotz's plate moved mesially during the fourth month after birth. In addition, the degrees of curvature on the palatal surfaces with Hotz's plate were less than those without Hotz's plate.
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Affiliation(s)
- K Mishima
- Second Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Osaka University, Japan
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Mishima K, Sugahara T, Mori Y, Sakuda M. Three-dimensional comparison between the palatal forms in infants with complete unilateral cleft lip, alveolus, and palate (UCLP) with and without Hotz's plate. Cleft Palate Craniofac J 1996; 33:77-83. [PMID: 8849863 DOI: 10.1597/1545-1569_1996_033_0077_tdcbtp_2.3.co_2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
A three-dimensional measuring system was developed to analyze changes in palatal forms of UCLP infants. This system quantified the change of the curved surface on a palate by automatically superimposing two wireframe models obtained from casts at different stages of growth. It also analyzed the curvature of the palatal surface. This system was used to study the palates of 20 infants with unilateral cleft lip and palate (UCLP), from the first to fourth months after birth (12 with Hotz's plate and 8 without, selected at random). Both major and lesser maxillary segments without Hotz's plate remained anterior and lateral although those with Hotz's plate moved mesially during the fourth month after birth. In addition, the degrees of curvature on the palatal surfaces with Hotz's plate were less than those without Hotz's plate.
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Affiliation(s)
- K Mishima
- Second Department of Oral and Maxillofacial Surgery, Osaka University, Japan
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Presurgical orthopedic management of the unilateral cleft lip and palate newborn patient. ACTA ACUST UNITED AC 1995. [DOI: 10.1016/s1071-0949(95)80004-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Huang CS, Cheng HC, Chen YR, Noordhoff MS. Maxillary dental arch affected by different sleep positions in unilateral complete cleft lip and palate infants. Cleft Palate Craniofac J 1994; 31:179-84. [PMID: 8068700 DOI: 10.1597/1545-1569_1994_031_0179_mdaabd_2.3.co_2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The development of the dental arch is well designed for adaptive and compensatory growth. In this study, the relationship between the sleep position and dental arch development was investigated. A group of 42 infants with unilateral complete cleft lip and palate with either prone (16) or supine (26) sleep position were seen in the craniofacial center. All infants were less than 1 month of age at the initial visit. Dental impressions of the maxillary arch were taken at the initial visit and just before cheiloplasty. Ten arch dimensions were measured in each dental cast and the longitudinal change in each dimension was compared between the prone sleep group and the supine sleep group. Statistically significant changes were detected in the growth rate of the following dimensions: intercanine width, intertuberosity width, alveolar cleft width, anterior cleft width, and posterior cleft width. This study indicated that sleep position affected maxillary arch development. Infants sleeping in the prone sleep position tended to have narrower arch width and cleft width.
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Affiliation(s)
- C S Huang
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan
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Larson M, Sällström KO, Larson O, McWilliam J, Ideberg M. Morphologic effect of preoperative maxillofacial orthopedics (T-traction) on the maxilla in unilateral cleft lip and palate patients. Cleft Palate Craniofac J 1993; 30:29-34. [PMID: 8418869 DOI: 10.1597/1545-1569_1993_030_0029_meopmo_2.3.co_2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Sixty-eight children born with complete unilateral cleft lip and palate were studied using dental casts taken at ages 0-0.1; 0.2-0.4; and 0.5-0.6 years of age. They were all treated with preoperative maxillofacial orthopedics using an external device (T-traction). The treatment was started after the first model was taken. Dental casts were analyzed regarding the morphology of the cleft region and the maxillary segments before and after treatment. The measurements were compared with measurements on dental casts of nontreated cleft children of similar age. The results suggest that a more normal anatomy of the cleft region occurs during the first 6 months of life whether preoperative maxillofacial orthopedics (T-traction) is used or not. However, this normalized growth seems to occur faster with the T-traction.
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Affiliation(s)
- M Larson
- Department of Jaw Orthopedics, University Hospital, Uppsala, Sweden
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Mølsted K, Dahl E. Asymmetry of the maxilla in children with complete unilateral cleft lip and palate. THE CLEFT PALATE JOURNAL 1990. [PMID: 2340639 DOI: 10.1597/1545-1569_1990_027_0184_aotmic_2.3.co_2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Craniofacial asymmetry was analyzed in 31 children with unilateral cleft lip and palate (UCLP) and compared to a group of 24 children with incomplete clefts of the lip (CL). Symmetry was evaluated from 32 variables on posteroanterior cephalometric radiographs. Two types of asymmetry were identified: In the first, there was a positional deviation and a change of arch shape of the maxillary segment on the cleft side. The basal maxillary width was similar in the two groups. At the dentoalveolar level a decrease in width was localized to the cleft side in the UCLP group. Maxillary height of the cleft segment was reduced. The second type was related to the anterior part of the maxilla and the nasal septum. The inferior border of the bony part of the nasal septum deviated towards the cleft side. The anterior nasal spine and the midpoint between the upper central incisors deviated toward the noncleft side, but to a different degree indicating a vertical tilting of the premaxillary region.
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Affiliation(s)
- K Mølsted
- Department of Orthodontics, Royal Dental College, Copenhagen, Denmark
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